Provider Demographics
NPI:1518140623
Name:REBECCA A PARKER DMD LLC
Entity Type:Organization
Organization Name:REBECCA A PARKER DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-581-9191
Mailing Address - Street 1:1325 BRIGHTON AVENUE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7633
Mailing Address - Country:US
Mailing Address - Phone:717-581-9191
Mailing Address - Fax:717-581-9166
Practice Address - Street 1:1325 BRIGHTON AVENUE
Practice Address - Street 2:SUITE 7
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7633
Practice Address - Country:US
Practice Address - Phone:717-581-9191
Practice Address - Fax:717-581-9166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028325L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty